Military hospitals in Afghanistan and the UK are operating close to capacity
as British forces prepare to launch a major offensive against the Taliban.

The numbers of wounded troops treated at the main British military hospital in Afghanistan, Camp Bastion, rose from 131 in 2008 to 300 from just January to October last year as operations intensified. Commanders are warning a renewed push will lead to a surge in casualties.

In the UK, those returning to Selly Oak Hospital in Birmingham and later being referred for rehabilitation to Headley Court in Surrey virtually doubled in the same period.

Now, on the eve of an joint operation involving an estimated 4,000 British troops, the National Audit Office has warned that medical teams at home and in theatre could struggle to cope with many more patients.

The report coincided with a separate warning from the Commons Defence Committee that seven years of fighting on two fronts in Iraq and Afghanistan have left the armed forces ill-prepared to take on any new tasks.

The Committee said that RAF pilots were unable to train because aircraft were tied up on operations, the Navy had too many commitments, while senior generals believed the Army needed another 10,000 troops.

Operation Moshtarak is expected to dwarf last summer’s Operation Panther’s Claw in which 10 British soldiers were killed and more than 100 injured.

British commanders have said that the operation - the biggest since the first Gulf war - could also generate the highest casualty levels seen so far in the eight year battle as forces try to wrestle control of some of the most dangerous areas of central Helmand from the Taliban.

According to the NAO public spending watchdog, medical teams at Camp Bastion are on standby and can cope with a short term increase by calling in off-duty staff.

But despite a surge in troop levels, it revealed that staffing levels there have decreased from 10 medics per 1,000 of the military population in 2006 to four per 1,000 in 2009, and a drawn-out battle could see them working around the clock.

In the UK, Selly Oak and Headley Court are already under pressure from a steady rise in numbers as the Afghan conflict intensifies.

In 2008, there were 573 patients - 254 with battle injuries - treated at either one or both of the two centres, and in 2009, there were 912 patients and 490 with battle injuries.

The NAO has urged the Government to step up its planning for possible scenarios involving a big increase in casualties.

As in July last year, it said, Selly Oak’s 90 trauma and orthopaedic ward beds for both military and civilians were operating at 80 per cent of capacity, with a third of beds filled by injured servicemen and women.

If the numbers of wounded predicted in the forthcoming battle materialise, the hospital could close its Accident and Emergency Department to civilian patients altogether, rereouting them to other hospitals.

Headley Court is also under pressure. Throughout 2009, the number of seriously injured patients there exceeded the 28 beds originally set aside for them, although not bed numbers overall.

The surge in casualties returning to the UK is in part to the credit of the "highly effective" medical care now provided by military medical teams, the NAO said.

It estimated that between April 2006 and July 2008, at least 75 UK, coalition and local casualties survived from Iraq and Afghanistan who might previously have died of their injuries.

But it also raised concerns about thousands of working days are being lost to potentially preventable less serious complaints like stomach bugs and sprained ankles, it found.

Rates of minor injury and illness among troops deployed to Afghanistan nearly doubled between 2006 and 2009, increasing from four per cent to seven per cent of the total, it found. In Iraq the rate went up from five per cent to nine per cent over roughly the same period.

The watchdog estimated that 6,700 days were lost in Afghanistan between October 2006 and September 2009 because of the increase.

Patrick Cordingley, commander of the Desert Rats in the first Gulf War, said the Government must provide all three medical centres with all the support they need over the coming months.

“This is concerning to hear,” he said. “The NHS has got to gear itself up and make sure that not only does it have the bed capacity, but that it has available sufficiently well-qualified and experienced surgeons otherwise it will clearly run into difficulties if large numbers of casualties begin to come back and quality of care could suffer.

“The quality of care provided by staff is Bastion is commendable but it is worrying if they too are working for extended periods of time because that is unsustainable.”